How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | None | $11.48 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.51 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.51 |
BCBS Wyoming Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $30.90 | Professional | None | $26.30 | $30.90 | $30.90 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $18.62 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $43.65 | Facility | None | $21.88 | $21.88 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $16.60 Typical High $16.60 | Professional | None | $11.48 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $5.75 Typical High $6.31 | Professional | 52 · Reduced service | $5.75 | $5.75 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.91 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.29 |
Where Wyoming sits
The same service costs 1.8 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wyoming· 3rd of 51
$16.60
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.